NEW 1 March 2018: At approximately 90 days or 3 months before My Aged Care assigns your Home Care Package they will send you a Home Care Readiness Letter.

The Home Care Readiness Letter is very new, we don’t yet have a copy of the letter to show you what the letter entails. However, according to the My Aged Care Operational Update Q1 2018 webinar presented by the Health Department, essentially the letter encourages you to:

1. Opt out of the National Queue if you are not yet ready to access in home care services through a Government Subsidised Home Care Package (more on that at the end of this article);

OR

2. Use the subsequent 90 days to “get ready” for the assignment of your Home Care Package if you plan to accept your Home Care Package.

What action do you need to take to “get ready”?

1. Research and choose your Approved Provider to administer your Home Care Package.

If you are an existing private care client of Daughterly Care you will most likely choose us to administer your Government Funding because that way you don’t have to change Carers – you can retain your existing Caregivers – we just use the Government Funding before we privately invoice you.

Daughterly Care Community Services has one of the lowest fees to administer a Home Care Package on the market. Since 27 February 2017, when Consumer Directed Care reforms were fully implemented over 100 Elders have chosen to transfer their Home Care Package away from their previous Old-School Approved Provider and transfer to a New Breed of Approved Provider called Daughterly Care Community Services.

2. The Health Department says the demand for Home Care Packages is “significant”. There are now over 100,000 Elders waiting for a Home Care Package. The Department acknowledges that many older people are waiting for High Care Packages i.e. Level 3 or 4. Of those 100,000 Elders waiting, My Aged Care have offered 40% an Interim Home Care Package (Level 2) which is lower than the high care Home Care Package (Level 3 or 4) that they were approved for.

You can see how little Government Funding you receive with an Interim Level 2 compared to the high care Home Care Packages of 3 and 4 on this page. So one decision you are likely to need to make is, do you accept an interim Level 2 Home Care Package while you wait for your Level 3 or 4 Home Care Package or just wait for your Level 3 or 4 Home Care Package?

Do you accept an Interim Level 2 Home Care Package?

For full pensioners, (provided you still require in home care) when you are offered your Home Care Package, your decision is easy – accept a Level 2, 3 or 4 without hesitation – it will be financially worth your while.

For part pensioners and self-funded Elders the right answer is more complex. Ring us to talk through whether it is financially beneficial to accept a Level 2 Home Care Package or whether you should just wait for your Level 3 or Level 4 Home Care Package to be assigned. Speak to your Co-Ordinator or High Care Case Manager and they, together with me, will advise what is best to do in your circumstance. We will do the mathematical calculations for you so that you can make a fully informed decision. There is no cost for our advice and no obligation to use Daughterly Care Community Services. We’re here to help.

3. Organise your Home Care Fees Letter from the Department of Human Services.

Time-saving Tip for Self-funded Eldersfor existing Daughterly Care clients. If you are 100% certain, you are 100% self-funded, you do not need to complete the whole 16 pages of the SA456 form. Just complete your name and state you are self-funded, then send it to the Department of Human Services. This saves completing 16 pages and you pay the same maximum Income Tested Care Fee anyway.

If you are in receipt of a full Pension or part-pension, you just ring DHS and ask them to send you your “Home Care Fee letter” as they already know your financials.

If you are self-funded or part funded or a part pensioner, an Approved Provider will not sign you up with a Home Care Agreement until you have your “Fee Advice Letter for Home Care” from the Department of Human Services or DVA stating what your Income Tested Care Fee is.

My Aged Care surveyed Elders who had been assigned a Home Care Package and who had NOT taken it up after 35 days…this is what they discovered…

30% of Elders were still trying to decide IF they would take up the offer of a Home Care Package – if you fall into this category call us on 02 9970 7333 and we can talk you through the costs versus the benefits to help you make your decision easy.

31% of Elders had decided NOT to take up the Home Care Package they had been assigned but had not yet opted out of the National Queue by informing My Aged Care. (I explain how to opt out later in this article).

54% of Elders who had been assigned a Home Care Package had not yet STARTED researching which Approved Provider they were going to use. I must admit we either get calls as soon as Elders are assigned their Home Care Package or when they have just a day left before the deadline to accept the assigned Home Care Package. There is little in-between with the ‘highly organised’ and the ‘running late people’.

How does Opting Out of the National Queue work?

My Aged Care would like the National Queue to be made of up of older people with a genuineand immediate intention to utilise a Home Care Package as soon as they are offered it. So they are hoping the 90 day Home Care Readiness Letter will encourage the 31% of people who have decided NOT to take a Home Care Package to Opt Out of the National Queue.

So if you had an ACAT Assessment but later your care needs reduced and it is unlikely that you need Government Subsidised in Home Care then you can tell My Aged Care that you will “opt out of the National Queue”.

Let’s say you are in position 100 on the National Queue, (99 older people will be allocated Home Care Packages and then it will be your turn) – what happens if you opt out of the National Queue? My Aged Care says you will retain your place in the National Queue if you decide to re-join later and therefore you are NOT disadvantaged by opting out of the National Queue.

My advice is this…do not Opt Out of the National Queue without talking it through with Daughterly Care. Often carers are telling us how stressed they are by their caring role but then don’t take-up a Home Care Package.

Carer stress is reduced by regular respite

So let’s talk through with you:

what is happening in your life;

how you are feeling; and

how having an in Home Care Package might assist you and your Loved One.

then you can make an informed decision regarding accepting or opting out.

It’s important you make the right decision for the person who needs support and care as well as the carer who is supporting and caring for their spouse.

If you receive a letter offering you a HIGHER Home Care Package than you are already on…

You do NOT pay any extra Basic Daily Care Fee when on a higher Home Care Package, it is the same fee across all 4 Home Care Packages.

Self-Funded Elders do not pay any extra Income Tested Care Fee than they are already paying when they were on a lower Home Care Package.

So you will receive more hours of support and care for the same cost to you, therefore accept the higher package immediately. Every day you delay in accepting is a day’s higher Government Funding forfeited by you.

I hope this article has been of assistance. Remember you can always ask us any questions. Remember, tell us as soon as your Home Care Readiness Letter arrives.

If you have friends waiting for a higher Home Care Package, forward this page to them.

Links to very helpful Information:

Have you been approved (on the waiting list) or assigned (the funding is there and ready to start paying for services)? There is a lot of confusion by consumers as to whether they are approved or assigned their Home Care Package or not – read this article to know for sure.

Hello Daughterly Care Caregivers and the families of our clients living with a dementia diagnosis,

Happy New Year

Let’s make 2018 a great year for us all and to that end I would like to introduce to you, Bob De Marco – the loving son of Dotty, who had Alzheimer’s.

Bob is an American son who gave up work to care full time for his elderly mother and shared his experience with the world via his daily blogging. His Alzheimer’s Reading Room is one of the most read blogs about dementia and it is full of practical advice.

This blog has been re-published here with Bob’s permission and at the end there is a link to his original blog. Please forgive his American spelling and his blunt and politically incorrect terms like “nutty behaviour”.

This article is well worth reading and if the advice is applied, it will reduce carer stress.

Alzheimer’s caregivers often feel enormous stress when their Loved One is mean to them; or engages in difficult behaviours that are hard to understand and accept.

by Bob DeMarco

Does this person look mean to you?

The list of difficult behaviors that Alzheimer’s patients express in the mid stage of the disease are long, and sometimes never ending.

It took me 3 years to figure out how to stop my mother from being mean to me. If you read this article and follow the links that explain how I did it, you can do the same thing in a couple of hours.

I couldn’t possibly list all of the mean and nutty behaviors my mother, Dotty engaged in those first few years of our life together with Alzheimer’s. The list is just too long.

For this article I am going to focus-in on one mean behavior: when my mother repeatedly told me to get out, she didn’t need me, and she could take care of herself.

I’ll start with a few words of advice to caregivers:

Many of you can probably imagine what it feels like when a person living with dementia tells you –

“I don’t need you, get out”.

Or, says something even worse than that.

So there I was. I had dropped out of the world to care for my elderly mother, 24 hours a day, 7 days a week, 3,112 days. Could she have said anything meaner, “I don’t need you, get out.”

It hurt.

These mean spirited episodes with my elderly mother went on for years before they stopped. However, I was never deterred by her mean spirited behavior because I made a decision from the very beginning – I am going to put a stop to this.

So I tried everything in the book. I tried being overly nice – didn’t work. I tried being overly positive – didn’t work. I tried explaining why she needed my help – didn’t work.
I told her if she didn’t start accepting my help she would end up in a “home” – that did not work. In fact, it made things much worse.

I tried everything I could think of doing – it did not work.

Finally, I threw the book away and started thinking. And then it happened.

I realised something had to change, and that something was me.

Pretty simple huh? Dotty wasn’t going to change so it was up to me to change. To change the entire dynamic of our relationship.

Shortly after my realization that I had to change, I invented a new place I first called Dotty’s World.

I started asking myself – why? Why does Dotty get so upset? What is happening that is making her upset? Is it me?

Yes, it was me. Okay, we had that out of the way. It was me.

Eventually I changed the name of our new world to Alzheimer’s World.

Alzheimer’s World was the place I would go to, to better understand Dotty and to better understand me.

At first, I found that it was difficult to change gears and get into Alzheimer’s World. So, I actually started taking a giant step to the left when I needed to enter Alzheimer’s World.

To be honest, I couldn’t get there without the step to the left. Just couldn’t.

Next, I started taking notes in a spiral notebook. Every time Dotty would get mean I would write down what was happening before these episodes.

One thing stood out. Every time I left Dotty alone, shortly thereafter, she would get mean.

“Get out, I don’t need you, I can take care of myself”.

It became obvious to me that I couldn’t leave Dotty alone. I couldn’t leave her alone for 30 minutes to go to the store. Or, for any other reason. This is pretty common in mid to later stage Alzheimer’s. A person who is deeply forgetful cannot be left alone.

Yes, there were other cataylsts to this mean spirited and often bizarre and crazy behavior.

For example, if I would tell Dotty you can’t do that. Or, if I would correct her and try to explain the errors in her thinking. Or, even if I would stop her from doing something.

Once I made it to Alzheimer’s World I started looking at the world from Dotty’s point of view.

I looked at the world from her eyes.

Pretty soon I realized that the things that Dotty would do seemed very normal to her. I just looked at her while she did them and pretty much kept my mouth shut.

Pretty quickly, almost overnight in fact, I accepted that the things Dotty did were normal in Alzheimer’s World. So, I stepped to the left to better understand. Amazingly, the amount of stress I was feeling diminished – it happened immediately.

In Alzheimer’s World instead of getting all bent out of shape, I found myself marveling at the things Dotty would do. The things that Alzheimer’s patients do are often fascinating. After all, their brain works differently than yours and mine. You have to start understanding the brain on Alzheimer’s.

Now to my first major point. When Dotty said,

“Get out, I don’t need you, I can take care of myself”

that is not what she meant. What she did mean is:

Don’t leave me alone, I’m scared, please don’t put me away in a home.Yep, she was scared and, like it or not, I was the one causing the fear when I left her alone.

Simple solution, I stopped leaving her alone.

Once I realized that there was a very different meaning to Dotty’s words in Alzheimer’s World, I was able to develop better and better solutions to problems.

In this case, I didn’t leave Dotty alone. But that is not all that I did. When she said “get out”, instead of getting all bent out of shape and reacting back at her, I did the exact opposite. What did I do?

I smiled, walked over to her, put my arm around her, and calmly said, in a clear, low, confident voice,

I’m not going anywhere, we are here together now, and I am going to take care of you.

It took a while, but yes, it finally sunk into her brain.

Alzheimer’s World is wild, sometimes crazy, a backwards place. I learned that in Alzheimer’s World words from an Alzheimer’s patient are often a cry for help. Many times what an Alzheimer’s patient says is exactly the opposite of what they mean.

So I started meeting meanness with an equal and opposite reaction – kindness.

Kindness, compassion, and understanding.

This is how you learn to cope with Alzheimer’s. Understand, cope, communicate.

By the way, Dotty stopped telling me to get out.

The few times she did tell me to get out I actually laughed. This helped me to realize how far I had come as a caregiver. Instead of enormous stress, I felt calm and comfortable.

If you follow the links in this article you will learn many of the lessons I learned over several years. The good news, it won’t take you years, it won’t even take days.

Once you incorporate these ideas into your life you will find that many of the things that are driving you crazy are normal in Alzheimer’s World. The amount of stress you are feeling will be greatly diminished by your new understanding of your loved one.

Here is the best part. Your loved one will begin to cooperate. So instead of feeling like they are the enemy, you will start to become good friends.The bottom line – it is up to you.

Wouldn’t you rather live a more happy life while caring? Wouldn’t you like to bring the highest quality of life possible to your loved one?

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What do you think – was this blog helpful for you?

Leave a comment below. Also perhaps you could share how you cope with being told to get out or other hurtful comments.

Cope. To face and deal with responsibilities, problems, or difficulties in an effective and calm manner or way.

Coping requires us to make our own conscious effort to solve personal and interpersonal problems. This allows us to minimize stress, reduce conflict, and to better understand our situation.

Emotional super glue a bond that holds two people together and rises to a level that is so powerful, so all encompassing, that it can only be described in this way – you are bonded together by emotional super glue.

Caregiver is a person who gives help and protection to someone who is sick or in need.

Empathy the ability to understand and share the feelings of another.

Compassion a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate their suffering.

Dementia care is the art of looking after and providing for the needs of a person living with Alzheimer’s disease or a related dementia.

Flexibility the willingness to change or compromise.

Anger is a normal, sometimes healthy, human emotion. However, when it gets out of control and turns destructive, it can lead to a deterioration in personal relationships and a reduction in the quality of life.

Loneliness often occurs in Alzheimer’s and dementia care because our family and friends abandon us.

This Festive Season Busy Adult Children will Discover their Elderly Parents are not Coping

When busy adult children spend extended time with their elderly parents this Christmas and New Year Season they may notice that their parents’ quality of life has declined and frankly, they need a little help.

It may come as a shock to recognise elderly parents are not coping the way they used to. As families grow and move interstate or further apart, it’s at the family gatherings like the festive season when we get together and spend time with each other that we are more likely to realise the differences in elderly parent’s appearance, responsiveness, demeanour, mobility, behaviour and tiredness.

Are these little changes that indicate age is being kind to them or are these warning signs that are showing a decline with Elderly Parent’s health?

Here are some signs to watch out for with older people (parents, siblings, friends, neighbours) that can indicate they are not coping as well as they have done before:

Medication not being taken?
You can see from the Webster-pak that your parent is not taking their medication, or taking it sporadically.

Unexpected disorder in their home?Your house proud parents are not keeping up. Old, off food in the fridge.

The 5 alerts to be aware of, as mentioned above are the major areas of concern that show prospective signs an elderly parent is struggling to cope with daily life that you can check on during this busy festive season.

Additionally, there are a number of other indicators you may not be on the lookout for, that your elderly parent is battling with tasks and chores that used to be easily undertaken by them.

20 Warning signs elderly parents are struggling to cope

Letter box is full or hasn’t been checked regularly.

Utility bills have not been opened or paid on time.

Dates are being forgotten and appointments have been missed with doctors, friends, family or services.

Meal are being skipped altogether as snacks are substituted for proper breakfasts, lunches, dinners.

Bins are full and not being emptied or the garbage has not been put out for collection or brought in.

Routine kitchen tasks are approached with confusion, or delays in coordination and forgetfulness.

Additional naps, siestas, or sleeps during the day that can alter night time sleeping habits.

Aids left around house to assist walking, resting, leaning against between rooms.

New wounds, scrapes, bruises and injuries incurred from knocking into things.

Loss of items dentures, glasses, dog lead, phone, keys.

Unawareness of date or time.

As tasks take longer, owing to arthritis or diminished dexterity, meetings take longer to prepare for.

Different clothing choices; pull on shoes, no buttons, no zips, as it’s easier to wear slip on clothes.

Behavioural changes; upsets and mood swings.

Kitchen fridge not well stocked, bathroom not kept clean and laundry piled high.

Are your elderly parents aware they get assistance in the home for just a couple of hours?

Withdrawal from usual activities owing to feelings of anxiety, or self protection.

Front and back doors left open or unlocked at night. Lights being left on when not needed. Windows left wide open when that is not appropriate.

In home care keeps Elders living safely and happily at home for life

In-home care solves many challenges Elders face. Our lovely experienced in-home caregivers can pop-in and spend 2 or more hours, provide over-night care or even around the clock, 24 live in care with your parent while you are working, travelling or busy with your children or grandchildren.

To book a couple of hours in-home care call our office on 9970 7333. We’re on-call 24 hours, 7 days a weeks after business hours for emergencies.

We hope you have a very Merry Christmas and wish you a Safe and Joyful New Year.